Children from immigrant families now account for 42 percent of uninsured children in the United States, reports a study in the March issue of Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
More than two-thirds of uninsured children with immigrant parents are US citizens, according to an analysis of nationwide survey data by Eric E. Seiber, PhD, of The Ohio State University College of Public Health, Columbus. He writes, "Initiatives to expand coverage or increase Medicaid and CHIP uptake will require decision makers to develop new policy and outreach approaches to enroll these children so they do not fall behind."
More Uninsured Children Are From Immigrant Families
Dr Seiber analyzed data from a U.S. Census Bureau survey for the years 2008 to 2010, including more than 2.8 million households annually. Each year's data included over 40,000 children living in immigrant families: those who had either immigrated themselves or had at least one immigrant parent.
By this definition, nearly one fourth of all US children in 2010 were living in immigrant families. Eighty-six percent of these children were native-born citizens, and another two percent were naturalized citizens. Thus, only 12 percent of children in immigrant families were non-citizens.
Overall, 42 percent of uninsured children in the survey lived in an immigrant family. The percentage of uninsured children with immigrant parents ranged from just four percent in Maine to 69 percent in California. "Having an immigrant parent is a defining characteristic of uninsured children," Dr Seiber writes.
After adjustment for other factors, children who were not citizens and those born in Latin America were most likely to be uninsured—by about 11 and seven percentage points, respectively. Language barriers played a role as well. For children living in a household where Spanish was the primary language, the likelihood of being uninsured was two percentage points higher.
Outreach Needed to Enroll Eligible Children of Immigrant Parents
While previous studies have shown that children living in immigrant families are more likely to be uninsured, less is known about what percentage of uninsured children who are immigrants or have immigrant parents. In 2000, a key study reported that 36 percent of uninsured children live in immigrant families.
The new results show that "approaching half" of uninsured children in the United States have immigrant parents, according to Dr Seiber. He adds, "Children living in immigrant families are the group most likely to miss key investments in their health and human capital."
The Affordable Care Act includes efforts to expand health care coverage to uninsured populations. But as the new study points out, many children living in immigrant families are uninsured despite being eligible for Medicaid. "With the future of immigration reform undecided, enrollment groups must provide a safe harbor for citizen children who may have undocumented parents," according to Dr Seiber.
He urges new policies and outreach efforts to expand health insurance coverage among children living in immigrant families. "Maine, Hawaii, Massachusetts, New York, and Illinois have been particularly successful in enrolling eligible children with immigrant parents in insurance programs, and are models for the rest of the country," Dr Seiber notes. He adds that California has achieved strong results with efforts at overcoming language barriers to Medicaid enrollment.